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Background Engaging patients and the public in clinical practice guideline (CPG) development is believed to contribute significantly to guideline quality, but the advantages of the various co-design strategies have not been empirically compared, making it difficult to choose one strategy over another. Objective This pilot study aims to document the acceptability, feasibility, and outcomes of 2 methods of involving patients in outlining CPG. Methods A single-blind crossover pragmatic study was performed with patients with traumatic brain injury. The patients experimented with 2 alternative methods of producing clinical practice recommendations (ie, a discussion group and a wiki). The participants rated the acceptability of the 2 methods, and feasibility was assessed using indicators, such as the number of participants who completed the 2 methods and the number of support interventions required. Experts, blinded to the method, independently rated the participants' outcome recommendations for clarity, accuracy, appropriateness, and usefulness. Results We recruited 20 participants, and 16 completed the study. The acceptability of the 2 methods showed little variation, with qualitative comments expressing a slight preference for the social nature of focus groups. Thus, both methods of involving patients in CPG development appeared feasible, and the experts’ opinions of the adapted recommendations were both positive, although the recommendations produced through focus groups were deemed more relevant to support clinical practice. Conclusions Our results confirm the acceptability and feasibility of focus groups and wikis to allow patients with traumatic brain injury to participate in clinical practice guideline production. This study contributes to the scientific literature by suggesting that the 2 methods were acceptable, feasible, and produced positive outcomes. Trial Registration ClinicalTrials.gov NCT02023138; https://clinicaltrials.gov/ct2/show/NCT02023138
Background Engaging patients and the public in clinical practice guideline (CPG) development is believed to contribute significantly to guideline quality, but the advantages of the various co-design strategies have not been empirically compared, making it difficult to choose one strategy over another. Objective This pilot study aims to document the acceptability, feasibility, and outcomes of 2 methods of involving patients in outlining CPG. Methods A single-blind crossover pragmatic study was performed with patients with traumatic brain injury. The patients experimented with 2 alternative methods of producing clinical practice recommendations (ie, a discussion group and a wiki). The participants rated the acceptability of the 2 methods, and feasibility was assessed using indicators, such as the number of participants who completed the 2 methods and the number of support interventions required. Experts, blinded to the method, independently rated the participants' outcome recommendations for clarity, accuracy, appropriateness, and usefulness. Results We recruited 20 participants, and 16 completed the study. The acceptability of the 2 methods showed little variation, with qualitative comments expressing a slight preference for the social nature of focus groups. Thus, both methods of involving patients in CPG development appeared feasible, and the experts’ opinions of the adapted recommendations were both positive, although the recommendations produced through focus groups were deemed more relevant to support clinical practice. Conclusions Our results confirm the acceptability and feasibility of focus groups and wikis to allow patients with traumatic brain injury to participate in clinical practice guideline production. This study contributes to the scientific literature by suggesting that the 2 methods were acceptable, feasible, and produced positive outcomes. Trial Registration ClinicalTrials.gov NCT02023138; https://clinicaltrials.gov/ct2/show/NCT02023138
BACKGROUND Family engagement refers to the active involvement of family members in the care and decision-making processes of patient care. The current literature lacks clear insight into family engagement in hospital settings because it does not adequately describe the specific domains experienced, the roles families play during inpatient care, or the extent to which these roles are documented in electronic medical records (EMR). Retrospective Chart Review (RCR's), a foundational methodology of clinical research for over eighty years, extracts both structured and unstructured data from the medical record. It can offer insight into which clinicians initiate and sustain engagement, as evidenced in the unstructured narratives such as a daily progress note. RCR's pre-pilot and pilot testing of an abstraction tool are critical steps in the developing the tool used for data extraction. OBJECTIVE This article aims to explain the stages before piloting (pre-piloting) and during piloting of an abstraction tool used for a Retrospective Chart Review (RCR) study. It also explores how these stages influenced the development of the final abstraction tool that was used to extract data on family engagement in hospital settings from the EMR. METHODS Using a centralized clinical data registry system, the Research Patient Database Registry (RPDR), and the electronic medical record (EMR), a list of 2053 medical records meeting study inclusion and exclusion criteria was generated. A draft abstraction tool was tested on 9 records until it became stable in a pre-piloting phase. After stratifying the records by race, a convenience sample of 135 Black patients, a randomized sample of 135 White patients, and 135 Asian and other patients were selected using a random number generator. The modified abstraction tool then was piloted on 10% of the sample frame (n=39). RESULTS During the pre-pilot stage, the tool was tested on a total of 9 records from the aggregate 2032 records. During the pilot phase, the abstraction tool was applied to 39 patient records taken from the sample population.Two-hundred and ninety-three patients were eligible for inclusion. CONCLUSIONS The pre-pilot stage standardized the abstraction tool and aligned the flow of the tool to the EMR. It also addressed possible data extractor assumptions. The pilot phase provided insight into the available information, potential problems, and necessary modifications and refinements before the abstraction tool was finalized for the remaining 405 records.
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